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FENCE/GATEType Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Approved Correction Re -Insp' Fee 103 c9La_tS For Inspector: 1 . O3iame & Date 44 1So P9ve -Pn/iA reAice., 3q8 Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date / Time Type Insp'n , A-t4 ! F.4.PA /t Permit No. 03 ` 375 Name Address a 6 d ,ka 99 sr Company Phone # For Inspector: 5 ' jIame & Date tNS 1 Ate+ • • M • ,fia x • 6 : 6 ... • ter • rg ■M c ra 0 L")014" com pie PI eube,e cle �A uc•'�e: de. zr -v -c �1•>c 3(' 2odd 2 63 oral e loo 10 r' G a CIS( -O N1Q(lmil 3o7 31Mr- id-= 1• Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: BP2003 -398 Printed: 3/12/2003 Applicant: KEITH REINHARD/ Owner: EDUARDO MENDOZA V� JOB ADDRESS: 260 NE 99 C3 Contractor v 1 Local Phone: Parcel # 1132060134320 Fees: Description Amount FEE2003 -1483 Building Permit Application Fee $60.00 FEE2003 -1484 CCF $0.60 FEE2003 -1485 Notary Fee $5.00 Total Fees: $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 9/8/2003 Work: CAR PORT GATE If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: In consideration of the iss with the plans, d ngs s myself, my age ps rvan Building Permit EDUARDO MENDOZA KEITH REINHARD/ ST Contractor's Address: Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 4 & 5 & E1/2 OF LOT 6 BLK 32 LOT SIZE Construction Value: $500.00 Page 1 of 1 (INSPECTOR) BY: to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity is or spgifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either REG x:01 031703 113E IMC #01 005517 CASH $65.30 VN Signed (Contractor or Builder) BY: SECTION BY DATE 3/e/0 Zoning lc�, Electrical Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY • • • • • • • • • • • • • • • . • • . • • • • • • • PERMIT APPLICATION CHECKLIST OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review Notary ❑ PROOi. F „ EfSjll • • • (Attach) ' • • : • . • ❑ HRS / DERM APPROVAL • • (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERNIIT FEES o $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) $ 5 O c) ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: ( x . 60) x/1000 ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee ()Ty. mii.: Dryer QTY. TYPE Outlet, Appliance ()Ty. Typi.: Service Repair QTY. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Q'FY. Minimum Fee . T1'I'I Condensate Drain QTY. "I'YPI? Generator Q"I'1'. T) PE Q "I'1'. Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING 'I'vii; A/C Condensate ()Ty. TITE Drains, Roof QTY. TYPE Miscellaneous Fixture Q"I'1'. 'FITS Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 • ••• • • •• • • • • • • • • •• • • • • • • • • • • •• • • • • •• • •• •• PERMIT APPLICATION .• INSTRUCTIONS: Please indicate the type of work being pecan fed and yuantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: PROPERTY OWNER Name F o.. v- A. O 1 4 e-r•N c .71_ �'O Address y ��ma 14E °14 91 Home Telephone 3 ns , 7S 9 _ 3 a r et , % 76S ::11Tb01 ,( _ _ t4 (77 ARCHITECT New Construction Name C' v a � \ C� 1 � v4 e�1 \ C . License No. Repair Demolish Address aG © Relocation of Structure 9 Telephone -� q , - 39 t e;',. Fax Add'I Attachment TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Demolish Alteration Interior Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be tLken tc; obtain a pern)4 from the Miami Shores Village: Step 1. Complete the attached permit application which m ust be%igned by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A PPL ICATION Job Address: 4 .2l0 Q 1 I et Yr Address Zip Folio Number Description of Work C O. r2 Po AT ' e Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property of Work 5 0 0 i Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection . • • • • • • • • • • • • •• • • ••• •. • • . • • • • Master Permit No. . Mk tiO City State PERMIT APPLICATION Sub Permit No. • . • • • • • • fl . j :lap ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING REC VAI.IDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTI are lin to Moi al*thsvgh Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or lfbCda is.. ; • ; • • • • 2. All construction of demolition areas MUST BE MAINTAINED IN A CL 'EAN! &E, Ta iv SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AA1D DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1 °' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STA IDA, CO ature of Owner Print Name Sworn to nd subscribed before me this 1 O r / I , ./, /I /h •► 1111■• �. AUL : ignature ;.Notary ' • lic - S . to of orida SEAL: • • • • • • • • • • • • ' • • • • : • • • • •. • MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE dbAicuel s ow P(- Angela M Becker • P Y My Commission 00150048 V Expires November 15, 2006 • • Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: • PERMIT APPLICATION Personally known OR, Produced Identification f ,(� / Personally known OR, Produced Identification Type of Identification Produced.,_1)— _ �/- ( cJ o�"' bType of Identification Produced: Notice to Properties with PbOls: • • ••If :the fenc — ' — e to meet . . •••• . • ,. � criter.ip as a Q ool • , barrier, the fence MIL .:. •raot be climbable and • •. *nails must be paced. • • • • •Bing the inside of iha• • atoPertY Pedestrian • gates shall have Mr* • • "dosing.'�rad. IatcMrlg • • devices insfalled At .S • minimum of 54" above ground. For further details see Section 424 of FBC. CHAIN LINK FENCE DESIGN DETAIL N.T.S. (ACCORDING TO THE F.B.C. SECTION 2224) ChainLinkFenceFt3C General Notes: 1. This table is applicable only to fences with unrestricted airflow. 2. Fabric: 12 -1/2 gage minimum. 3. Tension Bands: Use one less than the height of the fence in feet evenly spaced. 4. Fabric Ties: Must be minimum the same gage of the fabric. 5. Fabric Tie Spacing on the Top Rail: Five ties between posts, evenly spaced. 6. Fabric Tie Spacing on Line Posts: One less than height of the fence in feet, evenly spaced. 7. Either top rail or top tension wire shall be used. 8. Braces must be used at Terminal Post if top tension wire is used instead of Top Rail. 9. In order to follow the contour of the land, the bottom of the fence may Gear the contour of the ground by up to 5 inch without increasing table values to the next hioher limit. See Table Below < > 10'- 0" o.c. Max. See Table I Below < > Fence Height Up to 4' Over 4' •Or Over 5' to 6' Over 6' to 8' Over 8' to 10' Over 10' to 12' Over 12' Terminal Post Size & Thick 2 -3/8" x 0.042 2 -3/8" x 0.042 2 -3/8" x 0.042 2 -3/8" x 0.110 2 -7/8" x 0.110 2 -7/8" x 0.160 Terminal Post Footing 10" x 24" 10" x 24" 10 "x 10" x 24" 12" x 40" 12" x 42" Line Post Size & Thick 1 -5/8" x 0.047 1 -7/8" x 0.055 1 -7/8" x 0.065 2 -3/8" x 0.095 2 -3/8" x 0.130 2 -7/8" x 0.120 Line Post Footing 8" x 24" 8" x 24" 8" x 24" 10" x 36" 10" x 40" 12" x 42" Section 2224.1 FBC: Fences over 12' height shall be designed according to the loads specified in Chapter 16 (HVHZ). u 022! 0 Lc) co Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2003 -263 Printed: 2/14/2003 Applicant: .KEITH REINHARD/ EDUARDO MENDOZA Owner: EDUARDO MENDOZA KEITH REINHARD/ JOB ADDRESS: 260 NE 99 ST Contractor POPEYES FENCE & CONSTRUCTION CO Contractor's Address: 10801 NW 27 AVE Local Phone: Parcel # 1132060134320 Fees: FEE2003 -1025 FEE2003 -1026 Permit Status: Work: 5' HIGH CHAIN LINK FENCE If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be p . Sig 'ed: •W 320.1137.4 11-10.71Y2C0 Jib 17,03336.1 This Permit is granted to the contract ordinances pertaining thereto and with tl and approved by the proper municipal a authorization. A further condition upon 1 ordinances and regulations pertaining tc by his agents, servantAe ployee Signed' In consideration of the issuance to me b with the plans, drawings, statements or myself,"my agent, serv.; s or employes APPROVED Permit Expiration: 8/13/2003 PAY TO THE ORDER OF ,S1 F Building Permit Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 4 & 5 & E1/2 OF LOT 6 BLK 32 LOT SIZE Description Building Permit Application Fee CCF Total Fees: Construction Value: -7 o 3 tra Fence Company 17055 NW. 78th Ave. 9&zi ah, FL 33015 S Fl rat Union National Bank N ° flrstunion.com Org. 003 R/T 067006432 Amount $60.00 $0.60 $60.60 $900.00 1:0670064321:2624806 Page 1 of 1 B2 Total Fees: $60.60 Total Receipts: $0.00 DATE 2 i ,--Ap s /00 3823 63.643/670 BRANCH 13093 �o i $L& - 0.6 O DOLLARS o. bM. CONTRACTOR New Construction Name (-!::,r) r �/1 �/ License / q, ( / Address / /� ( 0 l r`) LA) 2:7 � . Telephone -76- ! L % r ax ^ L' 2 U J 7 v Qualifier N - Fax ' '1 " _ / ` " /° " PROPERTY OWNER New Construction Name d�v' 4711 )� ' 2€ . „.......W [ Address Z E- q s +- Home Telephone Business Telephone Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction / Enclosure Alteration Exterior V Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: • *Step t. • • • omplete the att;ichgtel rmit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow fot a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted Ifbbg with t1Zis perntit application. • • •StP/12.• :811ritit Lhe comglete ttpolication with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of yoxaerplication, you may be asked to submit additional information. Current Use of Property Proposed Use of Property Tenant Information •••• t ? ?LICATION gbAddress:• q 5T • / • Address • • A Folio , N / umber ! 1 ^ OM 5 Lot 7/ pypel Block 3 2 - Subdivision PB 10 PG PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT CHANGE (✓ ) ARCHITECT Name License No. Telephone Fax Master Permit No. Subsidiary Permit No. City escription of Work S State Zip f L C( -- Zoning Square Feet y� Units ker Value of Wor _` 1 900 Bldg Value Linear Feet Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT APPLICATION Floors Page 2 IiIPOI(i'ANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. • • • • 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION fret r fro •construttiontielris. • • 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. • • . • •••• • • 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR•STOIiAGE. A414444 • • required for work in or near the street/sidewalk. • • • • • 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES • 6fhgrconstruction may have a trailer which requires a separate permit. • • • • • • • • • •••••• • • • • • 6. PORTABLE TOILETS for a construction site require a separate permit. • • • • 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Buildinplo titning and rirli &dt. • • 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. •••• • • • • 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources • Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applicatiops sewers. • • • • • .. • •. • AFFIDAV1'1' - Please read ca refully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. Signature of Owner Signat STATE OF FLORIDA, CO NTY gF MIAMI - DADE int Name Sworn to and subscribed before me this Signature of No SEAL: day of S ANA o MhTAS O MY Comm Exp. 6/6/2003 No. CC 843457 1 1 Personaty Knonn 1) Der 1.Q Personally known OR, Produced Identification Type of Identification Produced: _ A IF FLORIDA, p . ntractor / Qualifier SEAL: ! S Print Name / �- Sv m to and subscribed before me this / day of i ei. i -"ems PERMIT APPLICATION ANA M. TORRES My Comm tap. 6/6 No. CC 843457 11 Personally Known I 1 °11r 1.D. Y OF MIAMI -DADE • Personally known OR, Produced Identification Type of Identification Produced: SECTION BY DATE —g/(1/0 Zoning ,mil Electrical Mechanical Plumbing Fire Public Works Structural n� Building Official f 26 Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond ❑ IMPACT FEE (New Construction) PERNIIT FEES $ ' O Metropolitan Dade County (C.C.F.) $ , v Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ OTHER (Specify & Attach) ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: 3 ( x . 60) '1000 (¢.005 /sq.ft.) (0.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) • • • • • • • •• • • • ❑ BPR APPROVAL' (Restaurants. • • • • •• •• • • • • • ❑ CONTRACTQB, gEGIST (On File) •••••• •• •• • •• • • • • • • • • • • •• • • • •• • TOTAL $ Q 1 v • • • • •• • • Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com • • • CONDITION OF APPROVAL • • 1;1.1:f :TRP.:,it 1. T1'1'h: 'pi m um Fee.... ,,y1 v. , TYI'li pryer QTY. I'YI'I': Outlet, Appliance Q'I'Y. 'I'YI'1': Service Repair (YI'Y. LIC Central 1 -3Ton i•:. .ran Outlet, Wall Service, Temporary Paint Booth 'Me Central :le7l'en •. •.FirePump Air Handler, Tons Outlet, Switch Piping, Flammable Liquid Signs . A7 . entral$ -15 Ton c • • • • • •Fixture - Fluorescent Process/Pressure Piping Oven Space Heater (kw) V/reentral.li,?Aton , • • • Fixture Light Parking Lot Lights Spas/Hot Tubs 4 tWE•dentral b+ Ton '.' ' Flood Lights Plugmold/Strip Subfeeds, No. of Amps endow 4 6 : " 'FPL - Load Central Posts Swim Pool, Commercial 'air Conditidtlgrt . • • Garbage Disposal Range/Range Top Swim Pool, Residential LhiUQr • - • •Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New 1\ !EC IIANICAL TYPE Minimum Fee QTY. i'VI'1'. Condensate Drain QTY. TYPE Generator (1'I'1'. 'I'1'I'1? Refrigeration, Tons QI' Y. A/C Central, Tons QTY. Cooling Tower - Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping - - -- Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance PLUMBING TYPE A/C Condensate on'. 'fvi'F. Drains, Roof on*. •TYl'I: Miscellaneous Fixture QTY. 'I'YI'I'. Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Draintield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: BUILDING ❑ ELECTRICAL PLUMBING ❑ ROOFING .,,, Owner of Building Architect Contractor or Builder Legal Description Address of Building ❑ Work to be performed under this Permit MIAMI SHORES VILLAGE, FLORIDA DATE 1 — 4'4\ : ! 195 Contractor's License No. ❑ PERMIT IN? 12529 Lot f Subdi- vision Value of Amt. of 1 f I - Project $ Permit $ s ! r1 This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with-the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications-that may have been submitted to and approved by the proper municipal authorities. This Permit. may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans • 'drawings or in the statements or specifications and th &he assumes responsibility for work done by his agents, servants or employees. Signe BY PECTOR In consideration of the issuance to me of this permit I afire to p rform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, ments or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assum ' responsibility for all work done by either, myself, my agent, servant pfemployee. • v � ;/ CON DR BUILDER f " BY` , AUTHORITY ..s